by Kristina FiorePhysicians do not appear likely to reduce the frequency of cervical cancer screening -- not even with the availability of the sensitive human papillomavirus (HPV) DNA test, researchers say.When given a clinical vignette of a 35-year-old woman with a normal Pap test and a negative HPV test, only 19% of the more than 1,200 physicians surveyed said they would wait three years before conducting another Pap test, Mona ...
July 2010
All Stories
Why this doctor felt compelled to go to Haiti
by David Chong, MDAs the world watched the greatest athletes gather to compete in Vancouver, I was on a plane to Haiti. Just getting on the plane was quite a feat.After I received an urgent e-mail for volunteer doctors from the University of Miami’s Project Medishare field hospital in Port-au-Prince, Haiti during an overnight shift at New York's Presbyterian hospital, I began to send frantic requests for coverage for ...
Primary care salaries need to be addressed to improve health care
Physician salaries are always a sensitive topic.A common view among health reforms is that doctors, in general, are paid too much. Various progressive pundits point to statistics showing that American doctors are the highest paid in the world.For many specialists, that may be true. But not for primary care.A recent Tweet by Ves Dimov pointed me to an article from the UK, stating that primary care doctors working in ...
Rosiglitazone (Avandia) stays on the market, with stronger warnings
by Emily P. WalkerAn advisory panel voted 20-12 to recommend that the FDA allow rosiglitazone (Avandia) to stay on the market, but most panelists want to see the controversial diabetes drug carry tougher warnings on its label.Wednesday's vote marks the second time an FDA advisory panel has essentially endorsed rosiglitazone. In 2007, a panel voted that while the drug appears to carry a ...
Treating intellectual disabilities in patients who can’t talk
Psychiatrists treating patients who can’t talk. Sounds fishy, doesn’t it?Well, I do it 2-3 days per week, and as strange as it may sound, it makes perfect sense.Let me explain.I provide psychiatric consultation services in a facility for people with intellectual and developmental disabilities. (Intellectual disability is the newer term for mental retardation). Some of my patients are short-term admissions from the community, and others are long-term residents of the ...
Fire in the OR and how hospitals should report medical mistakes
by Maggie MaharDid you know that if there is a fire in the OR during surgery hospitals in some states don’t have to report the event to anyone?When I read a recent story in the Cleveland Plain Dealer headlined, “Reporting Surgical Fires Could Improve Patient Safety in Ohio, Experts Say," I was stunned.The piece begins:
When fire breaks out and burns a patient during surgery in Pennsylvania, the hospital is required ...
Free clinics need more government funding
by Cole PetrochkoThe nation's free clinics provide medical service to 1.8 million patients annually -- more than half of those clinics operate without government funding and serve patients who are almost all uninsured -- according to the first census of free clinics in 40 years.Responses to a national mail survey by 764 free clinics in the U.S., reported in the June issue of the Archives of Internal Medicine, revealed that ...
Pregnant with triplets, and a premature delivery
An excerpt from The Preemie Primer.There’s a well-entrenched theory that OB/GYNs have the most complicated pregnancies.In reality most of us probably do not, but doctors remember complications most vividly when they happen to people they know and love. My pregnancy was, unfortunately, a good example of that old adage. Many of my colleagues who looked after me during that time have said, “It was the worst night of my life.” ...
Final meaningful use rules for electronic health records reaction
by Joyce FriedenThe Department of Health and Human Services has released its final rule on "meaningful use" of electronic health records with the goal of making it easier for physicians to comply."We want these objectives to be ambitious but achievable," David Blumenthal, MD, MPP, the department's National Coordinator for Health Information Technology, said at a press conference on Tuesday announcing the release of the ...
KevinMD.com recent media mentions, July 2010
I’d like to thank various media outlets for recently citing KevinMD.com.USA Today: Some doctors join Facebook, Twitter; others wary
As Nashua, N.H., internist Kevin Pho wrote in a USA TODAY op-ed piece in January, "there is little guidance on how physicians can incorporate (social media) into their medical practice." ...... Another roadblock, Pho said, is that doctors usually get paid only for talking to patients in the examining room, giving ...
What residents and medical students should wear in the hospital
by Vineet Arora, MD and Shalini Reddy, MDAt a recent meeting I attended, a vigorous discussion broke out about what medical students, residents and attendings should wear, and more importantly what they should not wear.Interestingly, patients have been asked to weigh in on this discussion. What to wear is also on the mind of many current second year medical students who may find themselves trying to take study ...
Cancer in a transplant kidney, is it the doctor’s fault?
May you never be an interesting case.That's a cautionary proverb familiar to medical professionals. While it's bad to get sick, it's much worse to get sick with something uncommon or unusual. The more fascinating a case is for doctors, the more difficult it is for patients. Difficult to diagnose, difficult to treat, and often difficult to survive.Kenneth Liew was doubly unfortunate. He was an interesting medical case and an interesting ...
The individual mandate and the impending Supreme Court challenge
The individual mandate is the single most controversial feature of the Patient Protection and Affordable Care Act (PPACA). Everyone who can afford coverage—unless an undocumented immigrant or exempted on religious grounds—is required to have it or pay a penalty of $695 or 2.5 percent of income.The rationale is straightforward: without a mandate, many people would wait until they needed care before buying insurance, driving up premiums for those with ongoing ...
Ecstasy overdose is becoming more frequent at rave parties
by Crystal PhendOverdoses of the "club drug" ecstasy at all-night rave dance parties may be a rising but under-reported public health problem, the CDC said.What may be the first public health investigation into the epidemiology of ecstasy overdose revealed that 18 patients landed in hospital emergency departments for illness related to the hallucinogenic stimulant within 12 hours after a Los Angeles New Year's Eve rave.This cluster of events was accompanied ...
Healthcare reform: Who’s getting stuck with the bill?
by Shelly TownsMany people have the mistaken idea that “socialized healthcare” means that medicine and care will now be free for everyone, but in all actuality, nothing could be further from the truth.The new healthcare bill represents one of the largest, most sweeping domestic policy changes in a generation, and aims to provide an estimated $940 billion in healthcare to over 32 million uninsured Americans (and that's only for the ...
When the doctor is the patient, humanism and competency matter
Over the past few weeks I’ve had ample opportunity to be on the other side. Not like some parents with chronically ill children or those with children who have suffered tragic illness. No, not like that; I am fortunate that hospitals aren’t a part of my family’s everyday (except for work). My children have had amazing fortune and I remain in awe of good health. Lately though, we’ve had some ...
Will Avandia survive the FDA advisory panel?
by Crystal Phend and Emily WalkerDespite hints that the FDA may be leaning toward pulling rosiglitazone (Avandia) from the market, it's going to be a tough decision for the advisory committee slated to begin meeting on Tuesday, and things could still go either way, leading endocrinologists predict."I think the FDA advisory committee is going to struggle with this because none of the data is conclusive," ...
How this OB/GYN handled her unexpected maternity leave
by RH+, MDAbout 3 weeks after my son was born I read this post and I was extremely jealous as I read about the author’s extended leave. As I began to consider my "maternity leave" I realized that I could quite possibly have a truly unique situation on my hands.I work in private practice and my husband is an amazing stay at home Dad. We had been waiting to ...
Health effects from the BP oil spill
by Aldebra Schroll, MDAs the oil continues to pour into the gulf from the BP oil rig, we are witnessing not only an environmental disaster but a potential health crisis too.It is not just the water that has been impacted the crude can become airborne in tiny particles and carried inland with the breeze. Those working to clean up are particularly at risk, as are pregnant women and people with ...
AMA health insurer report card finds need for more accuracy
A guest column by the American Medical Association, exclusive to KevinMD.com.There has been some notable progress in just two years since the American Medical Association's first National Health Insurer Report Card evaluated the claims processing performance of the nation’s largest insurers. Health plans have made improvements in the efficiency and transparency of their claims processes, but there is still a lot of room for improvement – and the AMA ...
Kevin Pho, MD
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Why more primary care doctors are referring patients to specialists
According to a recent study from the Archives of Internal Medicine, primary care physicians are referring more patients to specialists than ever...
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Should Google censor anti-vaccine claims?
One of the reasons there is such a movement against vaccines is the democratization of information, perpetuated by search engines like Google....
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Radiologists who cheat on their board exams: Who’s to blame?
In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: "Doctors around the country taking an...
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Doctors: Don’t be ashamed about going bankrupt
Are doctors really going broke? According to this piece from CNN Money, some are: "Doctors list shrinking insurance reimbursements, changing regulations, rising...
Physician
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Patients will understand an honest mistake if the doctor tells the truth
It was 1976 and I was a junior resident in urology at Baylor College of Medicine in Houston, Texas. I was assigned...
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Diagnosing an illness is an art
Diagnosis is the foundation on which all care and treatments rest. If the diagnosis is wrong, most probably so is the treatment. ...
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Physicians have a natural role as advocates
As physicians, we are often called upon to be advocates for our patients. Sometimes they have no other person to turn to....
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Our society expends huge sums on futile care
Mike was a runner, outdoors-man, and fitness nut. This was not so much as for health reasons as for "feeling good", but...
Patient
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How will the Baby Boomers age and die?
I love listening to life stories. As a hospice chaplain, I loved sitting with our patients and their loved ones engaging in...
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Patient engagement is the holy grail of health care
For health care professionals, patient engagement is the holy grail of health care. It is the key to patient adherence – a...
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Why do doctors delay hospice referrals?
This is a response to Deb Discenza's article requesting a one page informational sheet informing a patient about hospice or palliative care. This would...
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How touch can calm patients
So, Megen at Not Nurse Ratched wrote post recently about therapeutic presence. The following passage really caught my attention: "Question is: are...
Policy
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A lack of incentive for medical schools to train primary care doctors
A social media movement is happening before our eyes with action starting to take shape. The #occupyhealthcare movement has begun within to...
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What should be the stated aim of health care in America?
The triple aim of health care, as defined by the Center for Medicare and Medicaid Services (CMS) is: improving the experience of care, bettering...
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How Moneyball applies to healthcare
The storyline is familiar. An organization is challenged to achieve better results without spending more money. An executive is committed to obtaining...
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The problem of insurance gaps in cancer patients
Why are cancer organizations waiting until it starts to rain before they suggest buying an umbrella? “Join my Medicare Advantage plan and...
Tech
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Repetition is the curse of the doctor-patient engagement
How many times as a doctor do you ask the same questions over and over again as part of the routine process...
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Why the prognosis of patients is difficult
Many clinical decisions in older persons are dependent on life expectancy. For example, as life expectancy declines, cancer screening is likely to...
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Innovative technologies can markedly enhance safety
“To Err Is Human” is the title of the now famous book from the Institute of Medicine on patient safety published about...
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Google knows more about certain diseases than physicians ever will
Professor Gunter Dueck, is a calm and eloquent german mathematician who’s also the CTO of IBM Germany. He studied mathematics and philosophy...
Social Media
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The Internet is where patients go for pre-visit consultations
As a physician, technology cannot replace you, but it can make you more efficient and effective. This was the message from Richard...
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5 ways doctors can benefit from professional connections
Looking ahead to the next several months, I’ve found myself frequently wondering how many physicians will make this their year to take...
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Twitter Is my third office location
The physician’s decision to first dive into social media can be stress-inducing. Issues of time management, maintaining professionalism, and determining a return...
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The impact of social media on a physician assistant
The impact of social media on medicine could arguably be compared to the impact of the industrial revolution on the human condition....
